Purpose
To (1) define Substantial Clinical Benefit (SCB), Patient Acceptable Symptomatic State
(PASS), and Minimal Clinically Important Difference (MCID) for the visual analog scale
(VAS) Satisfaction in patients undergoing hip arthroscopy for femoroacetabular impingement
syndrome (FAIS), and (2) identify preoperative predictors of achieving each outcome
end-point.
Methods
Data from consecutive patients who underwent primary hip arthroscopy between November
2014 and January 2017 were prospectively collected and retrospectively analyzed. Inclusion
criteria consisted of patients with clinical and radiographic diagnosis of FAIS, who
failed nonoperative treatment, underwent primary hip arthroscopy to address the FAIS,
and had at minimum 2-year follow-up. Baseline data and postoperative patient-reported
outcome scores were recorded at 2 years postoperatively. To quantify clinical significance
of outcome achievement on the VAS)Satisfaction, we calculated MCID, PASS, and SCB
for this outcome measure. A multivariate logistic regression analysis was used to
identify preoperative predictors of achieving SCB, PASS, and MCID satisfaction.
Results
A total of 335 patients were included in the final analysis, with an average age and
body mass index (BMI) of 32.8 (standard deviation ± 12.4) years and 25.2 (standard
deviation ± 5.3), respectively, and the majority being female (69.3%). The values
on the VAS satisfaction were identified to represent MCID, PASS, and SCB, respectively:
52.8, 80.9, and 89.7. The rates of achieving clinically significant improvement on
the VAS Satisfaction was 85.6%, 68.1%, and 56.9% for MCID, PASS, and SCB, respectively.
A larger preoperative alpha angle was predictive for achieving SCB (odds ratio [OR],
1.076; P = .046), whereas lower BMI (OR, 0.955; P = .047) and larger preoperative alpha angle (OR, 1.12; P = .025) were predictors for achieving PASS.
Conclusions
This study identified threshold VAS satisfaction scores of 52.8, 80.9, and 89.7 for
achieving MCID, SCB, and PASS, respectively, at 2-year follow-up following hip arthroscopy
for FAIS. Furthermore, preoperative variables including larger preoperative alpha
angles and lower BMI are predictors of achieving superior clinical satisfaction.
Level of Evidence
Level IV, Case Series.
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Article info
Publication history
Published online: November 14, 2019
Accepted:
September 13,
2019
Received:
May 28,
2019
See commentary on page 743Footnotes
The authors report the following potential conflicts of interest or sources of funding: S.N. reports nonfinancial research support from Allosource, Arthrex, Athletico, DJ Orthopaedics, Linvatec, Miomed, Smith & Nephew, and Stryker; serves on the editorial/governing board for American Journal of Orthopedics and as a board/committee member for the American Orthopaedic Society for Sports Medicine and the Arthroscopy Association of North America; receives intellectual property royalties and is a paid consultant for Ossur; and received publishing royalties and financial/material support for Springer. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
This study received institutional review board approval: 12022108-IRB01-CR06.
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
